A Coaching Model Created by Cheryl Ewing
(Health and Wellness Coach, NETHERLANDS)
The diagnosis of a chronic illness is a very turbulent moment in any person’s life. Although the diagnosis occurs within that moment in time, symptoms have often persisted for months to years before the diagnosis and the clients have experienced a lot of personal difficulties leading up to the diagnosis of their chronic condition.
There are 4 key areas to consider during this time of diagnosis and the period of adjustment that occurs after the diagnosis.
The emotional rollercoaster
In many instances, it may be a relief to have months of symptoms and investigations validated with answers and a diagnosis. However, following the initial reassurance, the consequences of such a declaration come to the forefront of one’s mind. The fear and uncertainty surrounding chronic illness, the profound impact it will have on their life in the future and the sheer weight in the responsibility they will have to endure from now until.. forever!
Often, clients will experience the 5 emotions surrounding grief. Denial of their disease and the impact it will have on their lives from now on, the anger of ¨why me¨, the bargaining of ¨what if¨, the deep-seated depression of no way out and finally the acceptance of life and the circumstances of ¨this is how it is¨.
Facing your fears as an infallible human creates enormous emotional scarring that tends to revisit during periods of frustration and vulnerability. The burden of living with a chronic illness weighs heavy on the heart and the mind. From the moment of the diagnosis, the client is never the same again.
The practical component
The diagnosis of chronic illness often results in a flurry of activity in a client’s life. Their diary becomes clogged with doctors visits, blood tests and meetings with various healthcare practitioners. The administrative load of sorting out the medical insurance, and prescription medication add to the burden of responsibility and clients can quickly become overwhelmed with the level of time management involved during the early phase of diagnosis. As the client moves into more long term management, the requirements of persistent monitoring, annual blood work and appointments and general lifestyle management become burdensome and exhausting. Motivation wanes resulting in an avoidance style approach to care which is detrimental to the client and their overall wellness. Persistence and perseverance are integral to the effective management of a chronic illness.
The mental distress
Life is never the same when a client is diagnosed with a chronic illness. Every core component of their life is impacted by their illness. Most notably is the effect on relationships and their social interaction with family and friends, the burden on their family, the financial impact on their lives and the effect of the illness in their work environment. It is important to acknowledge these fears and create a foundation of support and structure to calm their anxiety and create a nurturing environment for the client.
The lifestyle adjustments
Managing a chronic illness can very quickly become a fulltime job. Alongside this, are the changes to lifestyle one may have to go through to support their illness. Changes in diet, physical exercise, regular testing and prescription medication are a few potential habits that may need to be implemented during this time. Negative habits like smoking or drinking may also need to be addressed. Support and action planning will help effectively assist the client in creating the right structure and environment for habit creation and habit avoidance.
SHIFT as a coaching tool for chronic illness
The SHIFT Coaching model is a multifaceted coaching tool that can be used in the initial phase of diagnosis or further down the line during the maintenance phase of living with a Chronic Illness. The SHIFT coaching model is easily adapted and can be assigned to each of the 4 key areas of consideration in Chronic illness diagnosis and management. The SHIFT Coaching model allows the client to zero in and focus on what is important in their lives and to let go of any negative considerations that may be a potential barrier for self-care in health and wellness.
SHIFT allows the client to:
SHIFT from the negative ⇨ to the positive
SHIFT from inaction ⇨ to action
SHIFT from judgement ⇨ to curiosity and growth
SHIFT from the future ⇨ to the now
SHIFT from self-sabotage ⇨ to the celebration
Surround yourself with positivity
There are many negative connotations around Chronic Illnesses. Clients tend to get sucked into all the negative aspects of the disease when in fact, there are a great many positives to direct attention to. Most importantly, living with a Chronic Illness is an ideal time to take control of one’s health and wellness and place importance on oneself as an individual. Illness can potentially be a great motivator to transform one’s life into a newer and superior version.
The important consideration when coaching during this phase is aligning the individual with their purpose and vision while still keeping note of the truths surrounding their illness. In other words, the life sentence becomes the lifestyle.
Questions to ask during this phase:
True life is lived when tiny changes occur. Leo Tolstoy
Harness the tools and information
In a world where we are drowning in information and resources, it is easy to become overwhelmed with the amount of information accessible and the validity of what we hear and read daily. We also tend to take each person for the word without curiosity and enquiry.
As an individual living with a Chronic Illness it is vital to take responsibility for one’s knowledge about their condition and the resources and tools that they, themselves can act upon to support themselves in managing a Chronic Illness. This is the action phase of the coaching model where clients have the autonomy to choose what action steps they would like to harness to aid their new lifestyle.
The most important aspect to this phase of coaching is for the client to realise that they are in the driving seat of their health and wellness and that by creating activities, they can create a lifestyle that supports both their purpose and vision.
Questions to ask during this phase:
Every action you take is a vote for the person you want to become. James Clear
Invite curiosity without judgement
A habit is a settled tendency or usual manner of behaviour that is commonly very difficult to establish or abolish. Through the ongoing process of adaptation, setbacks and difficulties will occur. A setback is not a failure. If a setback could be seen through the lens of curiosity then it is an opportunity for growth and learning.
In this phase of coaching, allowing the client the opportunity to learn through experience is vital for continued motivation and momentum in their journey. A perspective shift from judgement to curiosity and awareness will facilitate this learning process and encourage the client to have the same approach with many challenges they may face along the way.
Questions to ask during this phase:
Curiosity is the engine of achievement. Ken Robinson
Forget your future fears, focus on the now
There is a tendency to get caught up in fears surrounding one’s future self. Hyperfocus on the future can leave one feeling worn out and out of touch with the present reality. The mind becomes clogged with uncertainty and anxiety which may cloud the truth of the moment in which we find ourselves in. By focusing on the present, we limit overthinking and allow ourselves to savour the moment whilst planning for a low anxiety future.
Questioning the client on how they perceive their current lifestyle and situation allows the client to focus on what is important and what is currently in their control. It provides calmness to the chaos of Chronic Illness so that the client avoids the overwhelming weight of consequence through future fears.
Questions to ask during this phase:
The things that make me different, are the things that make me. Winnie the Pooh
Take time for acknowledgement and celebration
Change is always hard and challenging and yet progress occurs with small incremental steps that gain momentum over time. Failing to understand and acknowledge these small changes is failing to understand and appreciate growth. Acknowledgement is the acceptance of growth and who you are becoming. Taking time in celebrating successes will allow the client to see their transformation and their progress through their journey.
There are many ways in which to convey acknowledgement by the coach to the client. This can be achieved through the non-verbal facial expressions and posture or words and expressions to the client. As well as the coach’s acknowledgement of achievements, the coach can help the client explore their own successes through powerful questioning and exploration.
Questions to ask during this phase:
I am killing time while I wait for life to shower me with meaning and happiness. Calvin and Hobbs
References:
Clear, J. (2018). Atomic habits: Tiny changes, remarkable results: an easy & proven way to build good habits & break bad ones.